Provider Demographics
NPI:1760413173
Name:SCHULMAN, STEPHEN A (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:A
Last Name:SCHULMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:STEPHEN
Other - Middle Name:A
Other - Last Name:SCHULMAN
Other - Suffix:IX
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2214 EMERY ST STE 210
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-2469
Mailing Address - Country:US
Mailing Address - Phone:940-382-9448
Mailing Address - Fax:940-382-7509
Practice Address - Street 1:2214 EMERY ST STE 210
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-2469
Practice Address - Country:US
Practice Address - Phone:940-382-9448
Practice Address - Fax:940-382-9448
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG8649208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX75709Medicaid
TX752032137OtherTAX IDENTIFICATION NUMBER
TXGH11OtherBC/BS OF TEXAS NUMBER
TX1215071-02Medicaid
TX1215071-02Medicaid